Researcher(s)
- Nicole Kirn, Nursing, University of Delaware
Faculty Mentor(s)
- Lauren Covington, School of Nursing, University of Delaware
Abstract
Title: Beyond the Band-Aid: Barriers School Nurses Face in Student Mental Health Care
Background:
Poor mental health in students is associated with negative school performance and poor overall wellbeing. School nurses view student mental health through a holistic lens. They consider social determinants of health as root causes, identify physiological symptoms, and provide resources to students and families; and yet, they are often absent from student mental health conversations. The objective of this study was to identify the barriers Delaware school nurses face in addressing mental health concerns in Delaware’s youth.
Method:
We surveyed 94 Delaware School nurses during their 2025 annual statewide professional development day. Questions focused on barriers school nurses face in providing mental health support, family mental health referrals and resources, and how to strengthen inter-professional collaboration. We used qualitative content analysis to explore free-text survey responses and descriptive statistics for quantitative responses.
Results:
One-third of the surveyed school nurses worked in elementary schools, with over 50% serving New Castle County schools. Two-thirds of school nurses were between ages 40-59 years and 80% were White. Delaware school nurses reported occasionally assisting with mental health referrals to school counselors, community mental health providers, and/or primary care providers. Overall, nurses felt left out of discussions and decision-making around student mental health in schools. The top three barriers faced included lack of time (31%), lack of resources (15%), and/or lack of training or education (13%). School nurses identified increased inter-professional communication and involvement in mental-health-specific meetings with administrators, parents, and students as solutions to addressing the above-mentioned barriers.
Conclusion:
Delaware school nurses face barriers to addressing student mental health. Future work is needed to enhance systems of communication to facility school nurse involvement in mental health discussions among school administration and families.